The huge number of treatment options available today can offer patients an array of choices they may never have considered in the past. General dental practitioners are now able to offer more complex treatments. Cheaper materials and payment plans make these treatments accessible to a wider range of people, not just the wealthy.
The choices for patients don’t end there. Dental tourism, or direct-to-consumer products are aggressively marketed, making claims that are hard for patients to factcheck independently. This is in addition to the potentially exhausting number of choices patients have to navigate in daily life.
Choice overload is the condition of having so many options that you develop decision-fatigue and become too overwhelmed to make an informed choice. How can dental professionals introduce several options to patients, so they truly engage with and understand their choices, without leaving them feeling overwhelmed?
Decision fatigue
Research from the US estimates that the average adult makes around 35,000 decisions a day, with varying degrees of importance. Fatigue associated with constant decision-making can affect strategic thinking skills, leading patients to take a passive, irrational or impulsive approach to making choices.
Patients who are exhausted by options may additionally experience pain more acutely. The mechanisms behind this phenomenon may be linked to anxiety and the subjective experience of pain, as well as frustration tolerance, which is impaired in patients who are overwhelmed.
Ego depletion refers to the reduced ability to exert willpower when energy reserves for self-control have been exhausted due to decision fatigue. This can negatively affect executive functions involved in planning and decision-making. Planning, as a higher-order executive function, involves the complex coordination of other functions like working memory, attention, and cognitive flexibility. Ego depletion, in short, reduces the ability to draw on experience, to focus and make useful comparisons, and can lead to poor choices.
The impact of choice overload on executive function may be even greater for those with ADHD. Executive function, self-regulation and cognitive control can be impaired as a result of the condition, making those affected especially vulnerable to decision fatigue and burnout. ADHD can affect patients’ ability to discern the benefits of one course of action over another, especially under stressful circumstances.
Effortful choice versus passive acceptance
Leading patients through effortful choices based on large amounts of complex information can be challenging, especially if the patient is burned out. However, studies have found that no matter how stressful a decision might be, people not only prefer acting on their own decisions, but tend to enjoy greater physical stamina and perform tasks better as a result.
This enables patients – once they have engaged with difficult or overwhelming information – to participate in their treatment more effectively. Offering the right support with the decision-making process increases the chances that patients will absorb the relative benefits of different options and come to a confident decision.
How to help
Carefully discussing the risks and benefits of each option, without pressure, and providing clear, accessible, evidence-based information for patients to review on their own, can be very effective for those feeling overwhelmed by choices.
This forms part of the shared decision-making process advised by NICE – a collaborative approach where individuals and their healthcare professionals work together to make decisions about care. Shared decision-making emphasises selecting tests and treatments based on reliable information and the individual's personal preferences, beliefs, and values.
Fully informed consent
Shared decision-making empowers patients, ensuring they understand the potential consequences of various options – including doing nothing – through discussion and information sharing. Patient education is a key ingredient of successful collaborative care, and of ensuring consent gained is truly informed.
AeronaDental software offers a complete documentation package with which to engage and inform patients, as well as to securely obtain fully informed consent. With the innovative Design and Sign feature, practitioners can easily create templates for anything from treatment plans to patient assessments, surveys, and any documentation requiring a signature. Patients can easily access and sign documents, and all documentation is easily audited, for complete peace of mind.
When patients are exhausted by decision-making and are struggling to engage with choices offered to them, evidence suggests they can be tempted to remain passive, or make a hasty choice that they might later regret. Providing opportunities for them to collaborate in decision-making will empower them to engage fully with the best possible treatment.
References available on request.
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